title: Relapsed spontaneous spinal epidural hematoma associated with aspirin and clopidogrel.
abstract: An acute spontaneous spinal epidural hematoma (SSEH) is a rare spinal pathology. A 57-year-old man who had hypertension and had been on dual antiplatelet therapy with aspirin and clopidogrel for primary prevention presented with the sudden onset of mid back pain and monoplegia of the left lower extremity. Magnetic resonance imaging revealed an epidural hematoma, and the patient underwent emergency hemilaminectomy for evacuation. However, the symptoms worsened, and complete paraplegia developed. A second procedure to remove the recurrent hematoma was performed. No vascular malformation or other possible cause for SSEH was found other than the aspirin and clopidogrel medication. This case report describes relapsed SSEH caused by the combination of aspirin and clopidogrel medication and urges caution in prescribing dual antiplatelet agents.
authors.affiliation: Department of Rehabilitation Medicine, Seoul St. Mary Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Seong Hoon
authors.initials: SH
authors.lastname: Lim
authors.forename: Bo Young
authors.initials: BY
authors.lastname: Hong
authors.forename: Ye Rim
authors.initials: YR
authors.lastname: Cho
authors.forename: Han Seung
authors.initials: HS
authors.lastname: Kim
authors.forename: Jong In
authors.initials: JI
authors.lastname: Lee
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Kim
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Ko
mesh_terms: D001241:Aspirin / Q000009:adverse effects*; D000077144:Clopidogrel; D046748:Hematoma, Epidural, Spinal / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012008:Recurrence; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology; D020521:Stroke / Q000517:prevention & control; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin